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Thursday, July 26, 2012

The manager of a Detroit-area health care clinic was sentenced today to serve 40 months in prison for his leading role in a $7.42 million Medicare fraud scheme, the Departments of Justice and Health and Human Services (HHS) announced.

Miami-area resident Alejandro Haber, 27, was sentenced by U.S. District Judge Patrick Duggan in the Eastern District of Michigan in Detroit.In addition to his prison term, Haber was sentenced to serve three years of supervised release and was ordered to pay $5,333,906 in restitution, joint and several with his co-defendants, and was ordered to forfeit approximately $99,000 seized from bank accounts he controlled.

On Oct. 27, 2012, Haber pleaded guilty to one-count of conspiracy to commit health care fraud.According to plea documents, Haber conceived and oversaw fraud schemes at a clinic called Ritecare LLC. Ritecare later merged with a clinic called CompleteHealth LLC.Haber’s role was limited to the operation of Ritecare alone.

On July 24, 2012, Alejandro Haber’s father, Emilio Haber, was sentenced to serve 60 months in prison for his leading role in an $8.5 million Medicare fraud scheme.

According to court documents, w hile operating Ritecare, Alejandro Haber and his co-conspirators billed Medicare for medically unnecessary tests and services.Haber obtained patients for Ritecare through the payment of kickbacks to patient recruiters and directly to Medicare beneficiaries. The majority of patients were obtained through patient recruiters.Typically, co-conspirators at Ritecare paid patient recruiters $100-$150 per patient obtained, with $50-$75 to go to the patient in exchange for coming to Ritecare and subjecting themselves to medically unnecessary tests.

To justify the medically unnecessary tests, co-conspirators at Ritecare instructed the patient recruiters to have the patients feign certain symptoms.Haber admitted that co-conspirators also directly instructed patients to feign symptoms as well.The kickbacks paid to the recruiters and the patients were contingent upon the Medicare beneficiaries identifying the symptoms necessary to justify medically unnecessary tests. Consequently, the patients’ medical records contained false or fabricated symptoms allowing Ritecare to deceive Medicare as to the legitimacy and medical necessity of the tests it performed.The most expensive tests were nerve conduction studies.

Between approximately August 2007 and approximately October 2009, Haber submitted and/or caused to be submitted approximately $7.42 million in fraudulent claims through Ritecare to the Medicare program for medical and testing services that were procured through the payment of kickbacks, were medically unnecessary, and justified by deception and patient coaching.Medicare actually paid approximately $5.33 million on those claims.

Today’s sentencing was announced by Assistant Attorney General Lanny A. Breuer of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade; Acting Special Agent in Charge of the FBI’s Detroit Field Office Edward J. Hanko; and Special Agent in Charge Lamont Pugh III of the HHS Office of Inspector General’s (OIG) Chicago Regional Office.

This case was prosecuted by Assistant Chief Gejaa T. Gobena of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Philip A. Ross of the Eastern District of Michigan. It was investigated by the FBI and HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,330 defendants who have collectively billed the Medicare program for more than $4 billion. In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.